Addressing health disparities by providing evidence-based treatment in the Black Church

拟议的行政补充不会改变研究的具体目标或中心主题 然而，这项随机临床试验的战略，从补充申请的资金将提高 招募希望减少酒精使用的黑人个人，这是由于COVID-19造成的。 黑人/非洲裔美国人使用酒精和非法药物的比例与他们的白色同行相同，但 更有可能遭受与物质有关的负面后果。此外，他们不太可能发起 治疗时，与其他种族群体相比，当他们这样做，是不太可能完成 治疗或提供循证治疗。耻辱，对医疗系统的不信任，缺乏健康 护理覆盖率，护理途径复杂，社会经济地位较低，缺乏文化上知情的 治疗可能都是导致治疗启动率和参与率低的因素。因此，提供治疗， 替代设置，如黑人教会，一个高度信任的实体在黑人社区，是一个小说， 一个潜在的高度传播的战略，以改善获得循证治疗和酒精 这一重要人群的治疗效果。 我们正在通过行政补充申请额外资金，以帮助启动和保留 黑人在戒毒治疗中的作用该临床试验的过去参与者表达了挑战， 因此，我们已经拨出一部分补充资金用于运输。我们 还建议使用公共汽车通行证，使研究小组成员能够旅行更远的距离， 招聘和与社区合作伙伴的联系。这些努力将导致更广泛地传播 关于临床试验的信息。如上所述，黑人的保留率也较低， 比他们的白色同行更容易上瘾。所要求的补充的最大部分将是 用于增加项目的努力，社区卫生代表的立场。这一角色将作为 直接联系参与者，与之互动，并为可能 在研究的任何一个分支中都难以获得治疗。最后，为个人保护提供资金 本补充材料中包括了个人防护设备（PPE）和风险缓解策略，如空气过滤器，以说明 由于我们加强了努力，预计参与者会增加。教会保健基金 还需要发挥顾问作用，以增加参与。这一重要角色将继续与 参与者，因为他们完成了基于证据的CBT 4CBT模块在黑教堂手臂的研究。 此外，如果在这种新的环境中利用CBT 4CBT，再加上加强招募和 参与被证明是有效的，这将是一个廉价和可传播的战略， 解决美国有酒精使用障碍的黑人个体之间的健康差异。

The proposed administrative supplement will not alter the specific aims nor the central themes in the research strategy of this randomized clinical trial, however, the funds requested from the supplement will enhance recruitment of Black individuals who want to reduce their alcohol use, which was comprised due to COVID-19. Black/African-Americans use alcohol and illicit drugs at the same rates as their White counterparts but are much more likely to suffer negative substance related consequences. Moreover, they are less likely to initiate treatment when compared with other racial groups; and when they do, are significantly less likely to complete treatment or to be offered evidence-based treatments. Stigma, mistrust of the medical system, lack of health care coverage, complex pathways to care, lower socioeconomic status, and the scarcity of culturally informed treatment may all be factors underlying low treatment initiation and engagement. Thus, offering treatment in alternative settings, such as the Black Church, a highly trusted entity in Black communities, is a novel, and potentially highly disseminable strategy for improving both access to evidence-based treatments and alcohol treatment outcomes for this important population. We are requesting additional funds through the administrative supplement to aid in the initiation and retention of Black individuals’ in addiction treatment. Past participants of this clinical trial have expressed challenges in accessing treatment, so we have allocated a portion of the supplement to be utilized for transportation. We have also proposed to use bus passes to enable research team members to travel greater distances for recruitment and connections with community partners. These efforts will result in greater dissemination of information regarding the clinical trial. As indicated above, Black individuals also have lower retention rates in addiction treatment than their White counterparts. The largest portion of the requested supplement will be utilized to increase the effort of the project’s, Community Health Representative position. This role will serve as a direct contact for participants to interact with, and provide support and resources for individuals who may have challenges accessing treatment in either arm of the study. Lastly, funding for personal protective equipment (PPE) and risk mitigation strategies, such as air filters are included in this supplement to account for the anticipated increase of participants due to our enhanced efforts. Funds for the Church-based Health Advisor role will also be required for increased engagement. This vital role will continue to engage with participants as they complete the evidence based CBT4CBT modules in the Black Church arm of the study. Moreover, if the utilization of CBT4CBT in this novel setting coupled with enhanced efforts for recruitment and engagement is demonstrated to be effective, this would represent an inexpensive and disseminable strategy to address health disparities among Black individuals with alcohol use disorders in the United States.